21524 98TH AVE W (2).pdfPOSTED ON KROLL MAP NO.:
BUILDING DEPARTMENT Applicant ]Fill
n 1
PERMIT APPLICATION Inside Heavy 7LIncs JOB ADDREUS
NAME (on NAME OF BUSINESS)
— Va. 3
PERMIT
NUMBER
670581
ro�
REA YARD SETBACK
VA�CANTSITE
YE13 13 NO
VARIANCE NUMBER
TELEPHONE NUMBER
EXISTING STREET R/W ............ FT- DEFICL=Cy THIS PROPERTY
a S� 0 STREET
LA. N ST.
COUP. PLAN ST. R/W ............
P
C OM P.-
Vr- ........
—AEMARKS
CHECKED BY
0
Z
C-P
1
14
METER SIZE I SERVICE SIZE
I CLEARANCE
ICHEC BY
TELEPHONE NUMBW_
17�1-3 -0 / '2-- '
REXA 8
[] YES 13 NO
DNEW
RESIDENTIAL
El
GAS
LINE
El
NON-RESIDENTLI.L
SIGN
0
RETAINING
__
0
f7
WALL
DEMOLISH
0 ALTER
0
EXCAVATE
OR FILL
El
PENCE
( x Ft.)
.......... ..........
REPAIR
Q
PRE -MOVE
INSP.
1:3
swim
POOL
NUMBER OF STORIES
—NUMBER
OF
DWELLING
UNITS
Plan Check NO .....................
—FR—OPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, &butting streets)
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given to correct; and that I am the owner. or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORJIZES
ONLY TNE
NOTE: Permit Limit One Year (Except DE31OLITIONS which
WORK NOTED
ahsjI be completed In ninety days: MOVED -IN BUILDINGS shall be com-
pleted In six months.)
FIdNATU: 5ENT) ATE Sio ED
INSPECTION
T(VNLPR
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject Nolan Check Fee
PR 6.1107
This Permit covers work to be done on private property ONLY.
Any ormstruction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
0 YES 0 ITO
Valuation I Fee
APPLICATION APPROVAL
P,
No.
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
DIR7E T 'a SI,
\-:� - 6 r7
FILE Jq F,�_